The vertebral column, also known as the spinal column or simply spine, is a column of 26 bones in an adult body (24 vertebrae interspaced with cartilage in addition to the sacrum and coccyx). In adolescents, the column consists of 33 bones as the sacrum's five bones and the coccyx's four do not fuse together until after adolescence. The spine is further divided into regions: cervical (the neck), thoracic (upper back), lumbar (lower back), sacral, and coccygeal. In between the vertebrae are thin regions of cartilage known as intervertebral discs, which are made of a fibrous outer shell (annulus fibrosus) and a pulpy center (nucleus pulposus).
Sometimes the open spaces within the spine shrink over time, putting pressure on the spinal cord and the spinal nerves that travel through the spine. When this happens, the condition is called spinal stenosis. Spinal stenosis is a common cause of low back and leg pain due to the narrowing of the spinal canal caused by normal wear and tear. Spinal stenosis commonly occurs in adults over the age of 60.
Some of the common symptoms of spinal stenosis are:
- Burning pain, weakness, numbness, or tingling in a leg, arm, or buttock
- Pain or cramping in the legs when standing for a prolonged period of time
- In extreme cases, loss of control over the bladder and bowel movements
A visit to the physician is highly recommended if an individual experiences pain, numbness, or weakness in the legs, arms, or back that is persistent.
Spinal stenosis is diagnosed with a combination of physical examination and imaging studies. After discussing the individual's symptoms, the physician will examine patient. The physician may then order an X-ray, CT scan, or MRI scan to get a clearer image of the spine in order to confirm diagnosis and rule out any other possible causes of pain.
Treatment for spinal stenosis will vary depending on the location of the stenosis as the severity of the symptoms. Non-operative treatments focus on relieving pain as well as restoring movement.
Medication - Over-the-counter medication such as NSAID’s may help reduce pain and swelling. If these are deemed insufficient by your physician, they might prescribe stronger medication to relive pain and reduce inflammation.
Lumbar Traction - This approach utilizes weights to pull the bones back into place in order to straighten the lumbar spine.
Physical Therapy - Physical Therapists will often prescribe specific strengthening and range of motion exercises for the lumbar spine and abdominal muscles.
Epidural Steroid Injections - Injecting the area around the spinal nerves with cortisone, a powerful anti-inflammatory medicine, might aide in decreasing pain. This is done using real-time x-ray imaging (fluoroscopy). Oral or IV sedation may be offered to keep the patient comfortable during this procedure.
Acupuncture - This method uses needles to help relieve pain for less severe cases of spinal stenosis.
Chiropractic Manipulation - This method could be effective in reducing the pain caused by spinal stenosis, however it’s important to note that this could worsen symptoms for osteoporosis or a herniated disc.
Surgery - Operative treatment is typically reserved for individuals who have spinal stenosis that is interfering with their day-to-day activities. Minimally invasive microscopically assisted lumbar decompression at one level can be performed as an outpatient procedure for most patients. Operative microscopy allows a minimally invasive approach which allows you to go home on the same day and recovery occurs, in general, by 6 weeks.
CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY!
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